root canal treatment - NHS and private costs & pros and cons

Olympika

Thanks hethmar. The socket is now infected so back on the antibiotics. Seems never ending at the moment!

Chameleon - like hethmar says, it's really not bad at all. The idea of it is FAR worse than the reality honestly, and I was incredibly nervous about it.

Froglet

Again,Olympika,you have my utmost sympathy.I thought all your problems would go away when you had the tooth out.I have certainly done the right thing,mine is giving me no trouble at all.I do hope you feel better soon.What antibiotics are you on?

o2brich

domdent wrote: »

Some basics
Antibiotics rarely work on localized dental infections. They should only be prescribed if the the patient is unwell or the swelling is causing a severe reaction affecting the airway.

For patients with pain the most appropriate treatment is to remove the cause of the infection either start root treatment or remove the tooth.

It is possible to root fill a front tooth in 2 20 minute appointments if the dentists has all the specialist equipment available and does the procedure all day everyday.

Remember Rubber Dam is essential if its not being used ask why not

Can you please let me know why Rubber Dam is essential.

I was feeling really proud of myself because, having been dissatisfied with my NHS treatment over the last few years, I took Toothsmith's advice in his signature and found myself a new dentist (private practice). I must own up to walking by the door of the practice at least half a dozen times before I even dared go in to see if they would take me on!! When I saw the new dentist, he said I needed extensive cleaning (even though I had been to a NHS dentist every 6 months), my 4 front crowns needed replacing etc etc. He also did a scan as I had been having problems with a tooth for years and said the root canal treatment needed re-doing and he would use the rubber dam treatment.

It is at this point (not due to go until October to have it done) that all my new found confidence has disappeared and I have been having nightmares already about having the treatment. I did see a picture on this forum of a tooth being done this way and I think it has scared me (sounds silly I know but I am so scared of going to the dentist even for a check up). So I am just wondering why it is essential to do it this way. My new dentist did say he would do it another way if I really couldn't go through with it.

Toothsmith

Rubber dam isn't a 'treatment', it's just a way of isolating the tooth you're working on from the rest of the mouth.

A tooth lives in a bug-infested wet environment, and yet to do a successful root filling, you need to get the inside of the tooth clean and sterile.

How it's possible to get the middle of a tooth sterile when there's saliva washing around all over the place, and you're wrestling with a tongue whilst trying to hold a couple of cotton wool rolls in place is anybodies guess.

So - a rubber dam is a sheet of latex (or non-latex stretchy stuff if the patient has problems with latex) with a tiny hole punched in it.

That hole stretches over the tooth, and is held on with a little clamp. (Everything is numb remember, but even so, a well placed clamp is just on the tooth - not digging into the gum)

The dam is then held out of the mouth by being stretched over a frame.

This means that when the dentist looks down, all he can see is the tooth he's about to work on in a totally dry environment, no tongue rubbing against it, and easy to get to.

The water from the drill, the antisepticts and disinfectants he uses, and all the debris are caught within the dam, and so don't go down the patients throat, and there is absolutely no danger at all of a patient swallowing anything that might harm them.

From the patient's point of view, it does feel a bit odd when it's being put on, but once you realise you can still breath and swallow as normal, it really does make everything tonnes better.

Among my patients, the ones who generally like it best are the more claustraphobic ones. Because they have the rest of their mouth, and I just have the tooth I'm working on. The clamp helps them keep their mouth open, as they can sort-of rest on it, and the relief of not having all the water and chemicals trickle down your throat is immense.

I know what you mean about pictures of it - It doesn't look the worlds most comfortable thing - but believe me, when I got back into using the thing about 10 years ago, I had more patients thank me for it that hating it.

Off the top of my head, I can only think of 2 patients who really didn't like it - and to be honest, one of them was a right PITA who moans at just about anything I ever do anyway!

Relax, and let it happen. You'll wish every dentist used it for everything!

domdent

o2brich wrote: »

Can you please let me know why Rubber Dam is essential.

I was feeling really proud of myself because, having been dissatisfied with my NHS treatment over the last few years, I took Toothsmith's advice in his signature and found myself a new dentist (private practice). I must own up to walking by the door of the practice at least half a dozen times before I even dared go in to see if they would take me on!! When I saw the new dentist, he said I needed extensive cleaning (even though I had been to a NHS dentist every 6 months), my 4 front crowns needed replacing etc etc. He also did a scan as I had been having problems with a tooth for years and said the root canal treatment needed re-doing and he would use the rubber dam treatment.

It is at this point (not due to go until October to have it done) that all my new found confidence has disappeared and I have been having nightmares already about having the treatment. I did see a picture on this forum of a tooth being done this way and I think it has scared me (sounds silly I know but I am so scared of going to the dentist even for a check up). So I am just wondering why it is essential to do it this way. My new dentist did say he would do it another way if I really couldn't go through with it.

Rubber Dam helps by isolating the area that is being treated.
A bit like a special operating theater just for the tooth, as the mouth is like a crowded train with drunken football fans being sick etc.

Would you have an operation on the train or in a clean theater ?

Another example is when having white fillings it is important to have a dry tooth and the moisture from breath can affect the glue, would you have a car re sprayed outside in the rain or in the body shop using a paint room ?

A good idea is to desensitize patients by putting the dam on for a few secs and not doing any treatment.

o2brich

Thanks to both Domdent and Toothsmith for the replies.

'Among my patients, the ones who generally like it best are the more claustraphobic ones' ........ this is interesting 'cos since I saw that picture on here I've had nightmares about not being able to breathe and suffocating having the tooth done this way. Daft I know but once something gets into the mind .........!!

Toothsmith - I think you have put my mind at rest (a little) - thanks. I will try and stop worrying about it now as its obviously the best way to have the tooth done.

Olympika

Froglet wrote: »

Again,Olympika,you have my utmost sympathy.I thought all your problems would go away when you had the tooth out.I have certainly done the right thing,mine is giving me no trouble at all.I do hope you feel better soon.What antibiotics are you on?

Thanks went in again yesterday to have the socket scrubbed out, new dressing and stitches. Am on metranidazole :rolleyes:

hethmar

Poor kid, you certainly have been through it

xx

caverncity

This is a long story and a long drawn out dental work for my 15 year old daughter. To be brief our last dentist who has just finished NHS was told by our dental hospital that my daughter needs 2 root canals doing, our old dentist said he won’t do it as he doesn’t do that type of work and needs a specialist.
Anyway we have recently found another NHS dentist and we went there yesterday for checkups, he too has said he won’t do the work and she has to see a specialist at a cost of £600 per root canal.
Now I know the NHS dentist has undergone a big change but I was always under the impression that under 18 years and all your dental work is free or am I wrong, Daughter is very upset as she needs other work and is getting past from pillar to post as she has two teeth missing at the front and may need her gum splitting, but until the root canal work is done they wont look into that yet. As I said it’s a long story.

Also on another note my wife has been suffering with a strange taste in her mouth and really bad chemical type smelly breath, she visited her dentist many times who took x-rays etc but to no avail. They couldn’t find anything wrong. The other day she noticed a small white lump on her gum and when we went for our checkups yesterday at our new dentist he too noticed it and took an x-ray where he found that the previous dentist who had fitted a crown had bent the screw whilst screwing it into the bone and perforated the gum/bone. Dentist has said she will need an implant at a cost of over £1000 or a bridge at a cost of £600. He said that’s what’s causing the smelly breath, strange taste and has also now caused a problem with her gums.
Surely the other dentist would have seen this or he has and decided to ignore it due to his incompetence. Would she be better making an official complaint?
Thanks

alison999

caverncity wrote: »

Now I know the NHS dentist has undergone a big change but I was always under the impression that under 18 years and all your dental work is free or am I wrong,

on the NHS it would be free, did you ask why he wont provide this for you on the NHS?

caverncity wrote: »

the previous dentist who had fitted a crown had bent the screw whilst screwing it into the bone and perforated the gum/bone. Dentist has said she will need an implant at a cost of over £1000 or a bridge at a cost of £600. He said that’s what’s causing the smelly breath, strange taste and has also now caused a problem with her gums.
Surely the other dentist would have seen this or he has and decided to ignore it due to his incompetence. Would she be better making an official complaint?
Thanks

id ask the dentist that youre seeing now what he thinks, he may even be able to help with you with your complaint.